ABSTRACT
This chapter provides information for accessing the internal jugular vein to inserting 0.035-inch J-wire. It begins with a case scenario of a 59-year-old woman in the ICU with bacteremia and hypotension, who’s requires continuous infusion of multiple medications. The chapter then includes details on indications, contraindications, and information about supplies and technique. Pearls and pitfalls are also incorporated, providing additionalinsights and practical advice not always available in other textbooks or articles." Air embolus can be deadly and should be managed by immediate aspiration of air from the needle or catheter, if possible. If the patient is unstable, initiate advanced Cardiac Life Support; if stable, place the patient in the left lateral decubitus and Trendelenburg position to trap air in the right ventricle. Arrhythmias usually resolve as the catheter or wire is pulled out of the right atrium or ventricle; proper placement of the catheter is in the Superior vena cava.
